Lesion-Based Chest Radiography Image Retrieval for Explainability in Pathology Detection

Abstract

Chest radiography is one of the most common medical imaging modalites. However, chest radiography interpretation is a complex task that requires significant expertise. As such, the development of automatic systems for pathology detection has been proposed in literature, particularly using deep learning. However, these techniques suffer from a lack of explainability, which hinders their adoption in clinical scenarios. One technique commonly used by radiologists to support and explain decisions is to search for cases with similar findings for direct comparison. However, this process is extremely time-consuming and can be prone to confirmation bias. Automatic image retrieval methods have been proposed in literature but typically extract features from the whole image, failing to focus on the lesion in which the radiologist is interested. In order to overcome these issues, a novel framework LXIR for lesion-based image retrieval is proposed in this study, based on a state of the art object detection framework (YOLOv5) for the detection of relevant lesions as well as feature representation of those lesions. It is shown that the proposed method can successfully identify lesions and extract features which accurately describe high-order characteristics of each lesion, allowing to retrieve lesions of the same pathological class. Furthermore, it is show that in comparison to SSIM-based retrieval, a classical perceptual metric, and random retrieval of lesions, the proposed method retrieves the most relevant lesions 81% of times, according to the evaluation of two independent radiologists, in comparison to 42% of times by SSIM.